AccountId: 011433970860
ContactId: d1faf6e6-9a37-4138-a78d-b171323c52fd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 384000 ms
Total Talk Time (AGENT): 117164 ms
Total Talk Time (CUSTOMER): 99575 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/d1faf6e6-9a37-4138-a78d-b171323c52fd_20250519T16:00_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I'm looking for a claim status.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK. Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Sure just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Policy number is 02137652.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Patient first name is [PII]. Last name is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What's your date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK. And may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And how much is the total charge on the claim, Mr. [PII]?
[CUSTOMER][NEUTRAL] 6100.
[CUSTOMER][NEUTRAL] 9, I'm sorry, uh $6,191.
[AGENT][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] And for the future, you can check claim status online through our website at [PII] and that's just optional.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm. Do you have a procedure code?
[CUSTOMER][NEUTRAL] Procedure code?
[AGENT][NEUTRAL] Mhm. Where is the facility charges?
[CUSTOMER][NEUTRAL] Uh, um, yeah, I have procedure.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, I don't have that information. I'm sorry.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it's gonna be one more minute. I'm waiting on.
[CUSTOMER][NEUTRAL] This claim is billed as a uh as this claim is billed as a secondary from the Cigna. Cigna was a primary and it was uh
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] And I transferred to the to your insurance as a secondary insurance.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, I'm just waiting for the documents to see if this is your claim, um.
[CUSTOMER][NEUTRAL] It was, it was, it was built on [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm, OK, I don't see that claim here.
[AGENT][NEUTRAL] I don't see a claim for that amount.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] No issue.
[CUSTOMER][NEUTRAL] Um, so
[CUSTOMER][NEUTRAL] Could you please check patient's eligibility if patient is active on a date of service or not?
[AGENT][NEUTRAL] Oh sure, yes. Mhm.
[AGENT][NEUTRAL] Effective date of the policy is [PII] and it is active at the moment.
[CUSTOMER][NEUTRAL] Alright, um, may I know the mailing address?
[AGENT][NEUTRAL] That is a [PII].
[CUSTOMER][NEUTRAL] There we can fill the claim again.
[AGENT][NEUTRAL] OK. [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] Just a moment. [PII], [PII].
[AGENT][NEUTRAL] I mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] The zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Alright, timely filing limit to submit a claim as a secondary.
[AGENT][NEGATIVE] We don't have timely filing limits.
[CUSTOMER][NEUTRAL] All right. May I know, may I have your name, please?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] Alright, call reference.
[AGENT][NEUTRAL] We don't have reference numbers you can use my name and today if you will.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Is there anything else I can help you with today, Mr. [PII]?
[CUSTOMER][POSITIVE] Uh, thank you very much. Uh, thank you very much. Have a nice day.